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Your Teen

Teen Athletes Leading the Nation in Tommy John Surgeries

2:00

Teen athletes accounted for more than half of the Tommy John surgeries performed in the U.S. from 2007 to 2011 according to a new study. The surgery is actually an ulnar collateral ligament reconstruction (UCLR) graft procedure in which the ulnar collateral ligament in the elbow is replaced with a tendon from elsewhere in the body. Tommy John was the first Major League baseball pitcher to have the surgery and the nickname has now become common use.

 “Our results showed that 15- to 19-year-olds accounted for 56.7 percent of the Ulnar Collateral Ligament Reconstruction (UCLR) or Tommy John surgeries performed in the US between 2007 to 2011," said lead study author Brandon Erickson, MD, of Rush University Medical Center in Chicago, in a press release. "This is a significant increase over time with an average increase of 9.12 percent per year.”

Once a player has the surgery, he or she needs a good 12 to 15 months of recovery time before they are able to return to a high level of sport activity. Oftentimes, a second surgery may be required as the athlete continues to strain the ligament.

Baseball pitchers are the athletes that most often require the surgery because of the way they pitch; overhanded instead of underhanded. Many believe that the problems start in the teenage years with players who throw harder than ever and don't ever take a month off.

Dr. Erickson and his team looked at a private insurance database to identify patients who received UCLR surgeries throughout the US.

About 4 out of every 100,000 patients who had surgery between 2007 and 2011 had a UCLR surgery. These patients were overwhelmingly male, with 32 percent coming from the 15- to 17-year-old age group and 22 percent coming from the 20- to 24-year-old age group.

These surgeries grew at a rate of 4.2 percent each year between 2007 and 2011. And more than half were performed in the southern region of the US.

Another reason many teen athletes are susceptible to injury is that they play only one sport and play year-round, never giving their immature bodies enough time to rest and repair.

According to Dr. Erickson, more attention should be given to prevention because overuse injuries tend to occur in intensive training and high-performance games.

"The research numbers suggest that more young athletes believe that having an UCLR procedure performed earlier in their career may lead to the big leagues or a scholarship, even though only 1 in 200 kids who play high school baseball will make it to the MLB," Dr. Erickson said. "This paradigm shift needs to be evaluated further to help prevent overuse injuries in kids from the beginning of the season when most issues arise."

Some teens simply play through the pain without considering the possible long-term physical problems that could quickly end the career they worked so hard to attain. It’s up to the adults in their lives to watch over and give them the guidance they need to stay healthy. Parents and coaches need to make sure that their kids and students are following the safety rules established by the sport associations and organizations.

This study was presented at the American Orthopaedic Society for Sports Medicine's annual meeting. Research presented at conferences may not have been peer- reviewed.

Source: Beth Greenwood, http://www.dailyrx.com/tommy-john-surgeries-elbow-overuse-injuries-were-common-teen-athletes

 

 

 

 

Your Child

Kids Who Specialize In One Sport Have More Injuries

Kids who came to the clinic with injuries played organized sports an average of 11 hours a week, compared with fewer than nine hours in the uninjured group. Although the researchers did not specifically look at this, Jayanthi said he has noticed that more highly specialized sports such as tennis, gymnastics and dance tend to be linked to more severe overuse injuries.Because a child’s body is still growing, children who specialize in only one sport suffer repetitive injuries more often, a new study says.

In fact, kids are twice as likely to get hurt –playing just one sport- as those who play multiple sports said Dr. Neeru Jayanthi, medical director of primary care sports medicine at Loyola University Chicago Stritch School of Medicine. "We saw a pretty significant difference with this intensity of training, along with specialization," said Jayanthi. The findings are slated to be presented Monday at the American Medical Society for Sports Medicine annual meeting in Salt Lake City. Research presented at medical meetings should be viewed as preliminary. "It's been accepted for the last five years or so that kids who are not super-specific do better. They're cross-trained, so they're conditioned for other movements," said Dr. Kory Gill, an assistant professor at Texas A&;M Health Science Center College of Medicine. Jayanith’s research team had done earlier studies on 519 junior tennis players and found that the kids who only played tennis were more likely to get hurt. Jayanthi wanted to see if the same findings extended to other sports. "As a physician, you get frustrated seeing kids come in with injuries that keep them out for two to three months. It's devastating," said Jayanthi, who recently saw a young gymnast with a knee injury that will keep her off the mat for at least three months. Here, the researchers looked at 154 young athletes, average age 13, who played a variety of sports. Eighty-five of the participants came to the clinic for treatment for a sports injury, while 69 were just getting sports physicals. The investigation ranked each athlete on how specialized they were, basing the score on factors like how often they trained in one sport, whether they had given up other sports to practice just one, and if they trained 8 months a year or more to compete more than 6 months a year on one sport. What they discovered was that 60.4 percent of the athletes who had been injured were specialized in one sport, compared with only 31.3 percent who came in for physicals. Kids who came to the clinic with injuries played organized sports an average of 11 hours a week, compared with fewer than nine hours in the uninjured group. Although the researchers did not specifically look at this, Jayanthi said he has noticed that more highly specialized sports such as tennis, gymnastics and dance tend to be linked to more severe overuse injuries. Why did these injuries occur? "One reason is repetitive use of the same muscle group and stressors to growing areas, for example, the spine," explained Jayanthi, who stressed that the findings were preliminary. His team, in collaboration with Children's Memorial Hospital in Chicago, plans to enroll more athletes in follow-up research, and those athletes will be evaluated every six months for three years, to look more closely at how intense training can affect a young athlete's body during growth spurts. "Second is exposure risk," he added. "If you're getting really good at one sport, the intensity increases because you are getting better. People are developing adult-type sports skills in a child's body. The growing body probably doesn't tolerate this." Younger children -- those who have not entered high school -- tend to be especially vulnerable as their bodies are still growing, said Gill, who recommended that kids cross-train and condition for other movements, or just play another sport. "I tell parents to let kids be kids and play multiple sports," he said. "See what they're good at and what they enjoy." By high school, when bodies are more mature, specializing is safer, he added. When children play different sports in different seasons, they are using a wide range of motions and muscles. But when they begin playing one sport year-round, the risk of overuse injuries increases.

Daily Dose

Concussion Research

1.15 to read

Concussions were another topic for discussion at the American Academy of Pediatrics (AAP) meetings. While concussions continue to be on the rise and are most commonly seen among athletes involved in contact sports such as football, soccer, cheerleading and lacrosse, much of the literature has focused on when an athlete should return to play.  The AAP just published a report now looking at when an athlete should return to academics and school, rather than focusing solely on return to the field. 

While a concussion is a closed head injury sustained due to a blow to the head, students appear physically normal. There is not a scan or a physical exam that will diagnose a concussion but rather a constellation of physical symptoms that point to a concussion. Athletes will often complain of headaches, blurred vision, noise and light sensitivity, dizziness and mood changes.  These symptoms typically improve within 1-3 weeks after suffering a concussion, but during this time it may be difficult for a student to learn.

While the athlete is concerned about getting back to their sport, another challenge is returning to school and a rigorous course schedule. Therefore, it is important that parents, doctors and coaches understand that kids with concussions may have a hard time concentrating or learning new material.  They may also have problems with recall and testing. Returning to full throttle academics may also cause an increase in post-concussion symptoms. Slow and steady may be the best way to get a student back to learning.

It may be necessary to adjust a student’s academic schedule and allow them a gradual transition back to academics, just like has been proposed for return to play.  There needs to be collaboration with school, parent and child about how much their schedule should be modified.

Dr. Mark Halstead, lead author of report summed it up well when he stated, “the goal is to minimize disruptions to the student’s life and return the student to school as soon as possible, and as symptoms improve, to increase the student’s social, mental and physical activities.

These guidelines will help pediatricians guide their concussed patients  back to school and learning, before heading back to the field. 

Your Child

Tips for Preventing Sports Injuries

1:30

The school year is about to wind down and it won’t be long before many kids will be signing up for summer sports programs.

If you’re child loves sports, there’s not a season where he or she can’t find one to participate in. Sports often help children stay in better physical shape, feel good about them selves and with team sports, enjoy social interaction and competition.

However, all sports have a certain amount of risks associated with them - some more than others. The more contact the sport provides, the greater the risk for a traumatic injury. Fortunately, traumatic injuries are rare and most sport injuries to young athletes are due to overuse.

The most common sport-related injuries are sprains (ligament injuries) , stress fractures( bone injuries)  and strains (muscle injuries).Since children’s bodies are still developing, any tenderness over a bone should be evaluated further by a medical provider even if there is minimal swelling or limitation in motion.

The American Academy of Pediatrics offers these tips to help reduce serious injuries in younger athletes:

•       Time off. Plan to have at least 1 day off per week from a particular sport to allow the body to recover. 

•       Wear the right gear.  Players should wear appropriate and properly fit protective equipment such as pads (neck, shoulder, elbow, chest, knee, shin), helmets, mouthpieces, face guards, protective cups, and/or eyewear. Young athletes should not assume that protective gear will always protect them when performing more dangerous or risky activities.

•       Strengthen muscles. Conditioning exercises during practice strengthens muscles used in play. 

•       Increase flexibility. Stretching exercises before and after games or practice can increase flexibility. Stretching should also be incorporated into a daily fitness plan.

•       Use the proper technique. This should be reinforced during the playing season. 

•       Take breaks. Rest periods during practice and games can reduce injuries and prevent heat illness.  

•       Play safe. Strict rules against headfirst sliding (baseball and softball), and spearing (football) should be enforced. 

•       Stop the activity if there is pain.

•       Avoid heat injury by drinking plenty of fluids before, during and after exercise or play; decrease or stop practices or competitions during high heat/humidity periods; wear light clothing. 

While physical injuries are easier to see, sports-related emotional stress can also cause problems for some children. The pressure to win at all costs can add a lot of emotional stress to children who are more interested in playing than always being first.

Not every team is going to win every game, and there will be times when kids involved in more singular sports won’t have a good day. It happens to everyone at some time or another; ask any pro athlete. Young athletes should be judged on effort, sportsmanship and hard work. They should be rewarded for trying hard and for improving their skills rather than punished or criticized for losing a game or competition.  The main goal should be to have fun and learn lifelong physical activity skills.

There are numerous sports that children can engage in and each one offers its own benefits. As parents, it’s important to encourage our children and keep them as healthy as possible.

Source: http://www.healthychildren.org/English/news/Pages/Tips-for-Sports-Injury-Prevention.aspx

Your Teen

Cheerleading: Fewer Sports Injuries, But More Severe

2:00

Cheerleading used to be relatively simple sideline endeavor, but not any more. Today it can be a competitive sport, daring and sometimes dangerous.

It typically rates low in overall sports related injuries according to a recently published study, but because of the changing nature of cheerleading and how injuries are reported – whether as a sport or a nonathletic extracurricular activity- the ratings could change.

Researchers noted that while cheerleading may be more dangerous now than in the past, it still gets kids up and moving.

"Anecdotally, it's pretty clear to most people over the past few decades that cheerleading has shifted from a sideline activity to a competitive sport itself. This may have resulted in an increase in injury," said study author Dustin Currie, a doctoral student in epidemiology at Colorado School of Public Health at the University of Colorado Anschutz Medical Campus.

"We only have five years of data ... but I don't know whether to say it's better for cheerleading to not become a more competitive sport," he added. "If it's getting more children to participate in athletics, it's probably a net positive."

About 400,000 students in the United States participate in high school cheerleading each year, including more than 123,000 involved in competitive "spirit squads" that incorporate stunts, pyramids, tosses and jumps, according to the U.S. National Federation of State High School Associations.

But states classify cheerleading in various ways, with some defining it as a sport and others lumping it with other nonathletic extracurricular activities, Currie said.

The distinction is important because defining it as a sport requires stricter rules regarding practice location and other safety measures, as well as coaching certification requirements, he said.

The new study found that while overall injury rates are low for cheerleading, the injuries that do occur are more severe.

Researchers discovered that concussions were the most common cheerleading injury, involving 31 percent of all injuries. However, concussion rates were significantly lower in cheerleading that all other sports combined as well as other girl sports.

More than half of cheerleading injuries occurred during stunts, with pyramid formations constituting 16 percent and tumbling accounting for 9 percent. Most stunt- and pyramid-related concussions resulted from contact with another person, most commonly their elbow, the study said.

Currie said one way to potentially reduce cheerleading injuries would be for all states to change the classification of cheerleading to a sport and recognize that the "vast majority of high school cheerleaders are athletes" requiring the support of athletic trainers and other appropriate medical staff.

"States need to think about it in terms of cheerleaders being athletes, as they are now, rather than some recreational activity on the sidelines," he said.

The study was published online in the journal Pediatrics.

Source: Maureen Salamon, http://consumer.healthday.com/cognitive-health-information-26/concussions-news-733/as-cheerleading-becomes-more-competitive-concussions-top-list-of-injuries-study-says-706029.html

 

 

Daily Dose

Concussion The Movie

1:30 to read

As the end of football season is upon us, with bowl games for colleges and play offs for the NFL, a week does not go by that we don’t hear about a player who has been diagnosed with a concussion.   The debate surrounding football players and concussions will only get louder after the movie “Concussion” debuts over the Christmas weekend. The movie starring Will Smith will have broad appeal for kids and adults as it is a “sports thriller as well as a medical drama”.  “Concussion” is the story of the doctor, Bennet Omalu, and his discovery that concussions cause long term neurological consequences and his persistence in fighting the NFL. He forced the NFL to admit to the problem and his groundbreaking research has led to ongoing changes in the treatment of concussions both on and off the field. 

As a parent of 3 sons (full disclosure here), I must admit that  our youngest son played football. We had somehow managed to “dodge the football bullet” until the third boy came along. He was the most athletic ( is brothers would tell you that is because they taught him to play “up” with them in any sport”), and starting playing football while in elementary school. ( we are from Texas where football is king). Fortunately or unfortunately, he was good, as was his team, and they all went on to play through middle school where they won the league championship, and then into high school.  He loved the sport, begged us to keep letting him play and despite numerous conversations and our dismay that he wanted to continue to play football, he did play.  Of course we “bought him the best helmets” (not knowing then that studies would show that that is not enough) and we prayed every time he took the field that he would not get hurt.  He did get hurt. During his senior year he suffered a shoulder injury, had major surgery  taking a tendon from his knee to put into his shoulder,  and vowed never to play again!  He also figured out , “that he was not the best player on the team” which does not mean you can’t get hurt.

But, with all of the new studies and good data on CTE (chronic traumatic encephalopathy)  related to head injuries and concussions I called and asked him if he thought he had ever had a concussion???  Certainly, we never noted anything, but again this was 8-10 years ago. But to my surprise and in retrospect he thinks he probably did “have a couple of concussive like events” but he never told anyone about his symptoms…not his parents, coach or trainer…he only missed the end of his senior year due to his shoulder injury, not a concussion.  Thankfully he seems to be okay and is currently getting his MBA and does not even play recreational football.

So after reviewing all of the new data and the guidelines for return to play (RTP) and the the kids I have screened for concussions and kept out of games, I am not sure what I would do today if our child wanted to play football. That is the biggest question that parents are now facing….do you LET your child play football knowing about the risk of head injuries and the possibility of long term injury to a still developing brain??   Injury that may not be reversible?

Th AAP has recently come out with a zero tolerance policy for headfirst hits in football and the Council on Sports Medicine and Fitness has written the policy on tackling in youth football (Pediatrics. 2015 Oct 25) which includes seven recommendations to help make football safer. As Dr. Gregory Landry one of the lead authors states, “participants in football must decide whether the potential health risks of sustaining injuries are out-weighed by the recreational benefits”, and who is to decide, the parent, the under age child or both????

Good questions, but many differing opinions on the answers.

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